Recognising Early Signs Of Dementia: What To Watch For

Introduction

Are you feeling uncertain or concerned about the possibility of dementia affecting you or a loved one? You're not alone in your worries. Many individuals wonder about the early signs of dementia and how to recognise them. This article aims to provide helpful information on what signs to look out for and equip you with an understanding of the condition.

Definition of dementia 

Dementia refers to a condition with a noticeable decrease in cognitive abilities, making it challenging to carry out everyday tasks independently. This can manifest as difficulties in decision-making, thinking, or remembering. Usually, dementia is caused by different diseases that slowly harm nerve cells and the brain. Factors that can increase the risk of developing dementia include:¹

• Advanced age (more common in individuals aged 65 years or older)
• Excess weight or obesity
• Lack of physical activity
• Tobacco use
• Excessive alcohol consumption
• Elevated blood sugar levels
• Elevated blood pressure
• Social isolation
• Depression

Importance of early detection

While dementia is prevalent among older adults, typically those aged 65 and above, with projections nearing 14 million by 2060, it is crucial to understand that dementia is not a natural part of ageing.² Recognising early signs of dementia is essential for timely intervention and improved quality of life. 

Purpose of the outline

Early detection empowers individuals and their families to better navigate the challenges associated with dementia and plan for the future with confidence. Keep reading to dive deeper into understanding the differences between normal ageing and dementia, learning about the diagnostic process, accessing support services, and adopting proactive strategies to manage the complexities of dementia care.

Types of dementia

As we explore dementia, we come to understand that it is not just one disorder but a mix of different conditions. It can show up in different ways, like Alzheimer’s, Vascular dementia, Lewy body dementia, and frontotemporal dementia types, each bringing its own set of challenges. Thus it is important to understand these distinctions and symptoms to be able to provide appropriate care and support.

Alzheimer's disease

Alzheimer's disease is the most common type of dementia. It is caused by complex factors, including the excess of substances called amyloid and tau in the brain, forming plaques and tangles that disrupt brain function. Scientists are studying early changes in the brain and body fluids to better understand Alzheimer's causes and develop simpler diagnostic methods.³ While there's no cure yet, new medications target the disease's root causes to slow its progression. Some medications can temporarily improve memory and thinking skills, as well as manage symptoms and behaviours. 

Vascular dementia

Vascular dementia results from conditions that disrupt blood flow to the brain, impacting memory, thinking, and behaviour. Symptoms of vascular dementia can develop gradually or suddenly and worsen over time, but managing risk factors like high blood pressure, diabetes, and high cholesterol can help prevent further damage.⁴ Thus, living a healthy lifestyle is essential to reduce the risk of vascular dementia.

Lewy body dementia

Lewy body dementia (LBD) occurs due to abnormal protein deposits called Lewy bodies in the brain. These deposits disturb brain chemicals leading to issues with thinking, movement, behaviour, and mood. While no specific lifestyle factor increases LBD risk, conditions like Parkinson's disease and REM sleep behaviour disorder have been associated with a higher risk.⁵

Frontotemporal dementia

Frontotemporal dementia arises from abnormal protein clusters forming in brain cells, impairing their function. These clusters mainly gather in the front and side parts of the brain(frontotemporal), impacting language, behaviour, and planning abilities. Unlike most dementia, frontotemporal dementia typically begins at a younger age, commonly diagnosed between 45 and 65, though it can affect individuals both younger and older.

Common symptoms of dementia

Dementia can present itself in different forms but often shows similar symptoms. While these symptoms can vary in how severe they are and how fast they progress, they all bring significant challenges for those living with dementia. The most common symptoms of dementia are: 

• Memory loss
• Difficulty communicating
• Impaired reasoning and judgement
• Personality changes
• Difficulty with daily tasks

It is essential to note that while discussing common symptoms of dementia, certain types may exhibit some symptoms more frequently and not all individuals with each type of dementia will experience every symptom mentioned.⁶ For instance, Alzheimer’s disease may show mild symptoms of wandering, while frontotemporal dementia often presents issues with behaviour, movement, and language. Additionally, Lewy body dementia commonly includes sleep disorders, and vascular dementia may involve difficulties following instructions and hallucinations.

Early signs of dementia

As we talked about the symptoms of dementia, it is also important to understand the difference between the signs and symptoms of dementia. While symptoms are more subjective experiences reported by the individuals affected, signs are objective observations that can be measured or observed by others. Some of the early signs of dementia are mentioned here:

Memory loss

Memory loss is often one of the initial symptoms noted by individuals affected by dementia, impacting both short-term and long-term memory.⁷ However, the specific way memory is affected can vary based on the structural or functional integrity of the brain. Here are some common signs of memory loss: 

• Forgetting recent events or conversations
• Repeating questions or statements
• Misplacing items

Communication difficulties

Loss of language abilities is a common symptom of dementia. Early signs include difficulty finding words, especially when naming people or objects. As the disease advances, people suffering from dementia may forget the names of loved ones, become confused about relationships, and even fail to recognize family members. Studies indicate that people with dementia use fewer words, simpler language, and more fragmented sentences as the condition progresses.⁸ Communication difficulties in dementia can manifest like this:

• Struggling to find the right words
• Difficulty following conversations
• Trouble with written communication

Changes in behaviour and mood

Common changes in behaviour and mood include:

• Increased irritability or aggression
• Withdrawal from social activities
• Uncharacteristic apathy

These changes in behaviour and mood may also be a result of being stressed and confused, having trouble sleeping or experiencing problems with their sight or hearing. While we can not stop these changes, caregivers can help by creating a daily routine, focusing on their feelings, reassuring them, avoiding arguments, and asking for help when needed. These are some ways to deal with these personality changes. 

Impaired reasoning and judgement

Looking at judgement from a neuropsychological perspective, it involves various mental abilities like memory, language, attention, and reasoning, with a big focus on executive functions. Executive function involves the ability to do complicated tasks that need memory, planning, organising, putting things in order, and understanding abstract ideas. It is not just about thinking, it also includes emotions and social rules. Signs that someone is having trouble with reasoning and judgement might include:

• Difficulty making decisions
• Poor judgement in financial matters
• Inability to follow instructions or plans

Difficulty with daily tasks

Cognitive impairment increases the risk of functional difficulties in dementia patients, affecting their ability to care for themselves and do physical activities. As dementia progresses, individuals often need help with tasks like managing finances and household chores. Knowing the different stages of functional decline helps doctors create care plans that suit each patient's needs. This includes making lifestyle adjustments when needed. Signs of difficulty with daily tasks can look like:

• Challenges with household chores
• Trouble managing medications
• Getting lost in familiar places

Differentiating normal ageing from dementia

As we age, it is important to recognize the difference between typical changes in memory and cognition and signs of dementia. 

• Normal age-related changes: While minor forgetfulness, occasional difficulty finding words, and mild changes in mood or behaviour are common in ageing adults, they typically do not significantly impact daily life
• Red flags for dementia: However, persistent and worsening memory loss, a noticeable decline in cognitive abilities, and significant changes in behaviour or personality may indicate the presence of dementia and should be evaluated further by a healthcare professional

Seeking medical evaluation

Seeking evaluation from a healthcare professional is vital when noticing signs of dementia, as it enables accurate diagnosis and access to appropriate care and support. This process involves reviewing medical history, undergoing cognitive assessments, and sometimes, imaging tests like MRI or CT scans.⁹ Taking this important step can bring comfort and understanding to both individuals and their families.

It also opens doors to various supportive services and resources, like caregiver support groups, community programs tailored for those with dementia, and help with legal and financial planning. These services can help make people feel supported and positive about the future while also giving them a sense of belonging.

Summary

In conclusion, recognizing the early signs of dementia and seeking timely medical evaluation is paramount for ensuring appropriate care and support. As we age, it is normal to experience some forgetfulness and mood changes. But if memory loss, trouble thinking, or big changes in behaviour stick around, it is time to get checked out.

Doctors can help by looking at your medical history, doing some tests to check your thinking, and maybe taking pictures of your brain. This can help you and your family understand what is going on and find the right support. Remember, early detection empowers proactive management and planning for the future. With ongoing research and progress in treatments,¹⁰ there is hope for better support. By staying positive and making use of the resources available, everyone involved can feel included and resilient on this journey.